Pix'n'Mix Phase 3A (3) Flashcards by Alice O'Regan

Clinical features of carpal tunnel

Tingling 
Numbness
Worse at night 
Pain radiating down wrist 
Thenar muscle atrophy 
Thumb adduction

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List the contra indications of doing a lumbar puncture

Platelet less than 50 x 10(9)
Respiratory distress 
Shock 
Seizures 
Reduced consciousness

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Outline the mode of action of SSRI’s

Blockade of the reuptake of serotonin

Acts predominantly at the prefrontal cortex

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List the cancers which metastasise to the bone

Bronchus
Thyroid
Kidney
Prostate

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List the two endocrine agents used in breast cancer and where they target

Oestrogen receptor: Tamoxifen

HER2 receptor: Herceptin

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List the most common type of breast cancer

Adenoma

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Treatment of ? meningitis in the community

Benzylpenicillin (IV/IM)

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List the triad seen in Wernickles encapathlopathy

Intranuclear opthamolplegia
Ataxia
Confusion

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List the symptoms of delirium tremens

Clouding of consciousness 
Liluputian hallucinations 
Disorientation 
Amnesia 
Psychomotor retardation

Rx with Benzos

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Outline the key features of Juvenile myoclonic epilepsy

Onset adolescent
Seizures are myoclonic
Shortly after waking
Tiredness can increase the number of seizures

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List the predisposing of CHARGE

Coloboma of the eye 
Heart defects 
Atresia of the choanae 
Retardation of growth 
Genital abnormalties 
Ear abnormalties 
L

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List the predisposing features seen in NEC

IUGR
PDA
Preterm
Polycthmia 
Aphyxia 
Early rapid enthral feeding

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Key features seen on X-ray for

osteosacroma
edwings sacroma

Osteosarcoma: sunburst appearance

Edwings sacroma: onion skin

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List the features of androgen insensitivity syndrome

46 X,Y
No response to testosterone 
Structures don't develop 
Regression of the malarian inhibit factors
NOT A GIRL OR A BOY

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Clinical test used to diagnosis developmental dysplasia of the hips

Barloms

Ortalami

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Keys signs of abuse in a child

Torn frenulum labi superiourus
Scalds
Ligature marks

Outline the investigations that you would do in suspected MG

Tensilons test
Ach receptor abs
Nerve conduction studies
Ct for a thymoa

Features of mitral stenosis

Low volume pulse 
AF 
Raised JVP 
Undisplaced apex beat 
mid diastolic murmur

What does the median nerve supply

"LOAF"
Lateral lumbricals 
Opponenes pollices 
Abductor pollicis
Flexor pollicis brevis

What does the AMT consist of

Recall and address 
Date of birth 
Recognition of two people 
Place 
Year 
Name of monarch 
Name of prime minister 
Date WW2 ended 
Count backwards from 20

What type of anaemia is typically seen in alcoholics

Macrocytic anaemia

List the features of corticobasal syndrome

Presents as an asymmetrical cortical syndrome 
Gait unsteadiness 
Parkinsonism 
Aprexia
Alien limb syndrome

List the features of cerebellar lesions

Dsdiodochokinesia 
Ataxoa 
Nystagmus
Intentions tremor 
Slurred speech 
Hypotonia

Sign of phenytoin toxicity

Cerebellar syndrome

What are the features of an argil robertson pupil and what causes it

Pupil accommodates but does not react | Caused by syphillis

Name the hallucination commonly seen in coke addicts

Formications

Risk factors for suicide

``` Male Middle aged Depressed Previous attempt Substance abuse Chronic disease Organised plan No social support Self harm ```

Antidote to benzodiazapines

Give flumazeine

Define folie á deux

Shared delusional disorder where 2 codependent people develop a paired delusion

Causes of delirium

``` Degenerative disease Epilepsy Liver failure Intracranial injury Rheumatic chorea Uraemia Infection Metabolic ```

Management of hypercalcaemia of malignancy

Ca > 3mmol/L Rehydrate with 4-6L of normal saline over 24hrs Once rehydrated - IV pamidronate or zoledronic acid Monitor fluid status and serum calcium

Side effect of memantine

Hallucinations

Emergency management of APH

MILD - Set IV infusion - HB, cross match, grp and save - Obs - Locate placenta * placenta prevue stay in hospital until >37wks * minor abruption can go home if foetus not in distress SEVERE - IVI - Bloods - Raise legs - O2/15L - Fresh ABO/Rh compatible blood - Cathetise and monitor output - Deliver promptyl - Active management of 3rd stage

Emergency management of PPH

- O2 ( intubate if loss of consciousness) - x2 IV access large bore cannula - Bloods ( LFT's clotting) - Cross match 6 units ( put out haemorrhage alert 222) - IV fluids - Catheterise for UO - Deliver placenta - Bimanual compression - Drugs (Syntometrin, ergometrine, oxytocin infusion, misoprostolol, carboprostolol) - Take to theatre - Repair tears - Still bleed 1. Rush ballon 2. B-lynch suture 3. Internal iliac/uterine artery ligation 4. Subtotal/total hysterectomy